Nursing home closures have been concentrated in poor, urban areas, study finds

Nursing home closures have been concentrated in poor, urban areas, study finds

Over the last 10 years, nursing home closures have hit poor, urban and minority communities especially hard, according to a new study from Brown University.

During the period studied—1999 and 2008—the United States lost 5% of its nursing home beds. Nonhospital nursing homes were twice as likely to close in the poorest ZIP codes. They also were more likely to close in predominantly black and Hispanic areas. A change in Medicare payment policy in 1998 also forced closures of hospital-based nursing homes. Facility numbers declined by 50% between 1999 and 2008, also closing disproportionately in predominantly black and Hispanic, but not necessarily poorer, areas.

The result of the closures is that poor and urban people have less access to long-term care, according to the study, which was published in the Jan. 10 issue of the Archives of Internal Medicine. Family members of those who do find nursing homes usually have to travel farther to visit. The decision to close a nursing home leads to a dilemma, researcher Vince Mor said in a statement.

“If the local nursing home is closed because their quality is so poor, that's good, but the cost of that closure is disproportionately borne by a community,” he said. “How much do you invest in a failing facility and how do you make that investment without rewarding a bad actor who runs a lousy place?”

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